Pawłowska Katarzyna, Umławska Wioleta, Iwańczak Barbara
2nd Chair and Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
Department of Human Biology, University of Wrocław, Poland.
Adv Clin Exp Med. 2015 Sep-Oct;24(5):863-71. doi: 10.17219/acem/26337.
Lactase is an enzyme involved in the hydrolysis of lactose. Deficiency of the enzyme (hypolactasia) may be determined genetically or arise secondarily to disease of small intestine. Under this condition, lactose enters the colon where it is fermented by intestinal microflora and turns to gases and short-chain fatty acids, causing gastrointestinal symptoms known as lactose intolerance (LI).
To investigate the incidence of lactose malabsorption (LM), LI and the coexistence of these two conditions in children with upper gastrointestinal tract diseases (UGTD), malabsorption syndrome, inflammatory bowel disease (IBD) and functional gastrointestinal disorders (FGID).
Hydrogen breath test (HBT) was conducted in 387 pediatric patients in years 2010-2013. Two hundred thirty two children with gastrointestinal tract diseases were selected and assigned to groups - UGTD, malabsorption syndrome, IBD or FGID. For each group the frequency of LM, frequency and severity of LI and the frequency of their co-occurrence were calculated.
Lactose malabsorption was observed in 37.08% of patients with gastrointestinal diseases. Positive HBT result was the most common in children with malabsorption syndrome (52.50%) and less common in UGTD (30.85%), especially in ulcer disease (23.53%). Symptoms after lactose ingestion affected 36.64% of the subjects, and were more specific to lactose malabsorbers than to lactose absorbers (72.10% vs. 15.75%). The higher frequency of LI was noted in children with FGID, especially in irritable bowel syndrome (IBS) (65.22%). The lowest incidence of symptoms was obtained in children with UGTD, especially in those with ulcer disease (27.44%). The incidence of LM with LI was noted in 27.16% of all patients and was the highest in IBS (47.83%) and the lowest in ulcer disease (15.78%).
Lactose malabsorption is a common problem in children with gastrointestinal diseases, especially in children with bowel diseases. Lactose intolerance is related to LM, but does not affect all malabsorbers.
乳糖酶是一种参与乳糖水解的酶。该酶缺乏（乳糖酶缺乏症）可能由遗传决定，或继发于小肠疾病。在这种情况下，乳糖进入结肠，在那里被肠道微生物发酵，转化为气体和短链脂肪酸，导致称为乳糖不耐受（LI）的胃肠道症状。
调查上消化道疾病（UGTD）、吸收不良综合征、炎症性肠病（IBD）和功能性胃肠疾病（FGID）患儿中乳糖吸收不良（LM）、LI的发生率以及这两种情况的共存情况。
2010年至2013年对387例儿科患者进行了氢呼气试验（HBT）。选择232例胃肠道疾病患儿并分为UGTD、吸收不良综合征、IBD或FGID组。计算每组中LM的频率、LI的频率和严重程度以及它们同时出现的频率。
37.08%的胃肠道疾病患者存在乳糖吸收不良。氢呼气试验结果阳性在吸收不良综合征患儿中最为常见（52.50%），在UGTD中较少见（30.85%），尤其是在溃疡病患儿中（23.53%）。摄入乳糖后的症状影响了36.64%的受试者，对乳糖吸收不良者比对乳糖吸收者更具特异性（72.10%对15.75%）。FGID患儿中LI的发生率较高，尤其是在肠易激综合征（IBS）患儿中（65.22%）。UGTD患儿，尤其是溃疡病患儿的症状发生率最低（27.44%）。所有患者中27.16%存在LM合并LI的情况，在IBS中最高（47.83%），在溃疡病中最低（15.78%）。
乳糖吸收不良是胃肠道疾病患儿，尤其是肠道疾病患儿中的常见问题。乳糖不耐受与LM有关，但并非影响所有吸收不良者。
